Influence of Shielding Total Parenteral Nutrition From Photooxidation On The Number of Early Blood Transfusions In Extremely Low Birthweight Premature Neonates.

MedLine Citation:

PMID:
22487951
Owner:
NLM
Status:
Publisher

Abstract/OtherAbstract:

OBJECTIVES:: The smallest premature neonates often receive blood transfusions early in life. Non-restrictive transfusion policies are linked to deleterious outcomes. Exposure of TPN to ambient light (LE) generates oxidation products associated with haemolysis in vitro. Shielding TPN from light (LP) limits oxidation. Hypothesis: protecting TPN from light decreases haemolysis and therefore the need for early blood transfusions. METHODS:: Comparison of haemolysis between animals fed enterally and those receiving TPN, and exploratory case control retrospective analysis of transfusion counts in premature infants receiving LE or LP TPN. Statistical analysis: ANOVA and longitudinal binomial regression model adjusting for potential covariables of transfusion counts. RESULTS:: In animals: TPN is associated with higher (p < 0.05) haemolysis compared to enteral feeds; photoprotection induces lower peroxide load with no effect on level of haemolysis. In premature infants: LE (n=76) or LP (n = 57) populations exhibited similar clinical characteristics. Initial hematocrit, gestational age and index of disease severity had a significant effect on the number of transfusions. When adjusting for these covariables photoprotection was no longer significant. CONCLUSION:: Even though peroxides are associated in vitro with haemolysis, shielding TPN fom light to reduce infused peroxides does not significantly decrease the need for early transfusions in premature infants.